HomeMy WebLinkAboutBLDE-21-007441 Commonwealth of Official Use Only
E Massachusetts Permit No. BLDE-21-007441
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.1/07]
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:6/22/2021
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice or his or her intention to perform the electrical work described below.
Location(Street&Number) 327 STATION AVE
Owner or Tenant BOSSOLETTI MARY JO Telephone No.
Owner's Address 327 STATION AVE, SOUTH YARMOUTH, MA 02664
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appro �,k ox)
Purpose of Building Utility Authorization No. ��I � �
Existing Service Amps Volts Overhead 0 Undgrd 0 , M
New Service Amps Volts Overhead 0 Undgrd 04*43 4-1/
AT�j.
Number of Feeders and Ampacity F e 40,?
Location and Nature of Proposed Electrical Work: Install two exterior motion detector flood lights. O
Completion of the following table may be waive• , •r of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 44,
Transformers
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- CINo.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Siens Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee
provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such
coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME:
Licensee: Nicholas McEloy Signature LIC.NO.: 22642
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:31 Captain Carleton Road, Cotuit Ma 02635 Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License:
OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But
signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$50.00
-. ....k. Official
COIIMMOSW.4114 01niaeeact�iweelte Official Use Only '' LL
x ee�� Permit No. 66%-.2'e '7 7L--(LA
.w, eye,Meat e1.)la&awked
• Occupancy and Pee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. lro7j (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
Ail work to be pertbrmed in accordance with the Massachusetts Electrical Code(MEC)),! CMR 2.00
(PLEASE PRINT IN INK OR TYP ALL INFORMATI Date: lB ( 02
City or Town o!: cao
To the Inspector f Fl s:
By this application the undersigned ves no co his or her Intention to perform the electrical work described below.
Location(Street&Number) J 27 �1
Owner or Tenant IA4 GGV L( ,..10 FO5S0 [ Telephone No. 608. 570?-06 Us
Owner's Address
Is this permit in conjunction with a building permit? Ya 0 No (Check Appropriate Box)
Purpose of Building Utility Authorlatattor No.
Existing Service Amps / Volts Overhead 0 Usdgrd❑ No.of Meters
riev et _..__._ Amps / Volts Overhead 0 Uadgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Propaeed Electrical Work: Skcx-fit, d 'EL 4 oy- ase
01,
C. , ion ofibeibilewbut if#k ivy be waived by the Icor af Wires.
No.of Recessed Luminaires No.of Cell-Sssp.(Paddle)Pans o,of
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires swimming Pool rade ❑ trod. ❑ Hanes ►U�qlieilty UoBS
No.of Receptacle Outlets No. Burners FIRE ALARMS No.of Zones
~- No.otDeteelloa and
No.of Switches No.of Gas Burners Iattlatbatt Devils
--"'�` 'Total No.of Alerting Devices
No.of Ranges No.of Mr Coed. Tone
No.of Waste Disposers S p , a•lr.}Tot..„.1!, tt,�„„ To.otl . . ped
'WE __�-�L_in�te�
No.of Dishwashers Spiro/Area Heating KW Local 0 w*"T*'`r-r? 0 Other
Reefing Appliances KW u LL``
No.of Dryers g pp . '. 'I 4...i4c1. ' .' , _.
OAP Heaters KW Sips Ballasts
Data W�Irit' t
No.N dronsassa Bathtubs No.of Motors Total HP T , - %lilt
� ►':'i*. tdv enc ,
Y p �
OTHER:
Q at/ Attach additional detail((desired or as required by the inspector of Whys.
Estimated Value of lectri I Work: 7��' (When required by municipal policy.)
Work to Start: (e p inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE CO RA : Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation”coverage or Its substantial equivalent. The
undersigned certifies that such coverage is In force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE Ci BOND 0 OTHER 0 (Specify:)
I carte,under the pains and prodder of perjury,Oust the infortnation on this application 4 owe and complete.
FIRMNAME: Cane Cod ElectricalLIC.NO.: 12# 42.A
Liceaseet Signature ���/ LIC.NO.:
(/'applicable,enter"exempt”in the license number line.) Bus.TeL Nat 1640-44139
9
Address: . Alt.Tel.No.:
*Per M.O.L.o. 147,s.57.61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability Insurance coverage normally
required by law. By my signature below,i hereby waive this requirement. 1 am the(oho: owner's
Owner/Agent PERMIT FRE:$ S'0-
Sigaatare Telephone No.
Email: Office@capecodelectrlcla at.cam